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America’s Nursing Schools: Where We Are Now

September 16, 2011 - As the new school year unfolds, many nursing leaders and nursing workforce experts are looking toward the future with measured hope.

“We know that times are tough economically, but schools of nursing--and certainly our members--are dedicated to achieving the goals for a better educated workforce at the baccalaureate level and at a higher degree level through the doctorate,” said Kathleen Potempa, Ph.D., RN, FAAN, president of the American Association of Colleges of Nursing (AACN).

Mary Sue Gorski, Ph.D., RN, noted that two landmark reports released in 2010--the Educating Nurses: A Call for Radical Transformation report from the Carnegie Foundation for the Advancement of Teaching and the Institute of Medicine’s (IOM’s) The Future of Nursing report--have bolstered the conviction of many in the profession about the need to remain committed to providing excellent education for the future nursing workforce, even with the current economic challenges.

“It gives us all renewed enthusiasm and clout, shall we say, to go forward with the things we’ve been working on and knowing were important,” said Gorski, a fellow with the Center to Champion Nursing in America.

Admissions and enrollment are promising

Despite the sagging economy and a slowdown in hiring in some parts of the country, the interest in nursing among potential students has remained high. Over the past few years, nursing school applications have continued to increase.

In fact, AACN data shows that the number of completed applications to entry-level baccalaureate nursing programs almost doubled between 2004 and 2010, increasing from 122,194 to 242,013.

Many nursing leaders are also banking on the promise of the national centralized application service, known as NursingCAS, which was launched last year. The idea for the system arose from the concern that many nursing schools had to turn away highly qualified applicants, while others schools had vacancies that went unfilled. For example, AACN found that 55,000 qualified applicants were turned away from baccalaureate and graduate programs in 2009, even though 14,000 available spaces were not filled.

NursingCAS provides a convenient way for students to apply to a number of nursing schools, but the system also helps fill those slots that might otherwise remain vacant, explained Tim Gaspar, Ph.D., RN, the chairman of the AACN’s NursingCAS advisory group.

Nearly 100 schools participate in NursingCAS last year. More than 7,200 undergraduate applications and almost 500 graduate applications were received during the 12-month period from March 2010 to March 2011.

NursingCAS also has the potential to help the nursing workforce diversify to meet the needs of a changing patient demographic, Gaspar said. The first season of applications also showed a promising increase in the number of minority candidates; 36 percent of undergraduate applications came from minority students, which is more than double the 17 percent of the nursing workforce that is represented by minorities. Additionally, almost 15 percent of the applications came from men; men currently represent only about 6 percent of the nursing workforce.

Gaspar’s own school also logged an uptick in applications from men and minorities since joining NursingCAS.

“It helped us recruit a really good student body, and it helped us recruit a very diverse student body,” said Gaspar, the dean of the college of nursing at the University of Toledo.

Needed: A more highly educated workforce

Over the last few years, there has been a growing emphasis placed on the importance of a highly educated nursing workforce that will likely have an effect on nursing schools for years to come.

The IOM report called for nurses to achieve higher levels of education in order to provide the best possible patient care. Some influential nursing leaders, including Linda Aiken, Ph.D., RN, called for more resources to enable more nurses to begin their nursing careers with baccalaureate degrees.

Not everyone agrees. For example, in early 2011, the National League for Nursing released a paper titled “Academic Progression in Nursing Education” to reiterate its support for multiple entries to practice while still calling for high standards.

Even so, the IOM’s message has been received. Community colleges in at least 17 states are now offering baccalaureate degrees in a number of programs, including nursing. Some states are even forming partnerships between universities and community colleges to allow students more flexibility in how they earn their bachelor’s degree, while making the best use of limited faculty resources.

“The evidence supports that the higher-educated nurse at the bedside increases safety for the patient,” said Gorski, noting that she believes there is certainly a role for the associate degree nurse but that there is also a need for more baccalaureate-prepared nurses at the bedside.

Wanted: More nursing faculty

The ongoing faculty shortage is a perennial problem, especially as enrollments increase.

“I can tell you that nursing schools are struggling in keeping pace with that added enrollment pressure,” said Potempa. “We’re hardly keeping up.”

A September 2010 report from the ACCN titled “Special Survey on Vacant Faculty Positions” noted that 880 faculty vacancies were identified in 556 nursing schools with baccalaureate and/or graduate programs. That didn’t even include the need for more than 250 additional faculty members to meet demand.

Nursing has benefited from some preferential funding over the last few years, Potempa said, so state and federal budget cuts are worrisome. But she hopes that the source of funding for nursing education, including the education of future faculty members and programs to support them in this endeavor (such as loan forgiveness) will remain robust. There may be a greater need for more partnerships, too.

“We need to have a pathway for sustained funding,” she said.

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